Effects of Blood Flow Restriction Training Combined With Conventional Physical Therapy on Pain, Muscle Architecture, Strength, Function, and Psychosocial Outcomes in Chronic Lateral Epicondylitis: A Pilot Randomized Controlled Trial

BACKGROUND Chronic lateral epicondylitis (LE) causes persistent pain and functional impairment. Blood flow restriction training (BFRT) can improve strength and pain under low-load conditions, but evidence in chronic LE remains limited. This study investigated the effects of combining BFRT with conventional therapy on pain, muscle strength, function, and psychosocial outcomes. MATERIAL AND METHODS A single-blind randomized controlled trial was conducted with 22 participants diagnosed with chronic LE (>3 months). Participants were randomly assigned to an Experimental Group (EG; BFRT + conventional therapy) or a Control Group (CG; conventional therapy). After 2 dropouts, 20 participants (10 per group) completed the 6-week intervention. Both groups received 60-minute supervised sessions twice weekly, consisting of conventional modalities and progressive exercise. In the EG, BFRT was applied at 40% to 50% of individual arterial occlusion pressure. Outcome measures included pain intensity (NPRS), pressure pain threshold (PPT), pennation angle (PA), pain-free grip strength (PFGS), wrist extensor strength (WES), functional performance (PRTEE, Quick-DASH), fear-avoidance beliefs (FABQ), and health-related quality of life (SF-12). RESULTS Both groups demonstrated significant improvements in pain, strength, and function (P<0.05). The EG exhibited greater gains in PRTEE (P=0.001) and Quick-DASH (P=.025) scores, as well as larger improvements in FABQ (P=.039) and the physical component of SF-12 (P=.003), compared to the CG. Between-group differences in pain and strength changes were not statistically significant. No adverse events were reported. CONCLUSIONS BFRT combined with conventional therapy effectively enhanced functional and psychosocial recovery in patients with chronic LE. This low-load, time-efficient adjunct appears safe and beneficial for improving rehabilitation outcomes.